guest: there are multiple bacteria, viruses, occasionally parasites or toxins that can contaminate. areone we looked at closely three of the deadliest bacteria, , andli, listeria salmonella. the three of those account for 90% of the multistate outbreaks we track. other bacteria and viruses more likely to contaminate food at the point of preparation or seeumption, so we will viruses more commonly as localized outbreaks. can cause serious problems, e. coli can be severe and cause kidney failure and in some people, death. -- hysteria -- leased area listeria can cause convocations for pregnant women and everyone who gets a serious infection will have it in other parts of

the body like the what stream. common, it ismore less likely to be severe but still out there. host: what is the difference between the three of them? are there different contaminants, different bacteria? guest: these are three different bacteria. what they come from is a very interesting and in some ways surprising story. traditionally, we thought salmonella would come from eggs and chicken, that's why there's an april the fda has passed being implanted. -- implemented. chicken is less likely to be contaminated and we are insistent on cooking chicken adequately to avoid salmonella. we are seeing from a very wide friday, e. coli, listeria, and salmonella from many different foods. we were surprised to see a caramel apple outbreak.

and iceseen listeria cream. salmonella from a variety of different sources whether it's nuts or spaces. we're seeing different bacterial contamination and there are two fundamental reasons. one is we are looking more carefully. the more you look, the more you find. second, there has been a consolidation of food industries. you have large suppliers and if there is one of them and that large supplier it will be widely distributed. host: does it make a difference if it's organic? have seen food outbreaks associated with both organic and nonorganic food. as far as we can tell, organic food is neither safer nor less safe in terms of contamination. host: we are talking about foodborne illnesses with the director of the cbc, dr. tom frieden. calls and comments.

,emocrats, host 202-748-8000 republicans, 202-748-8001, independents, 202-748-8002. who gets sick from this and why? just clarify the frontlines, the original this morning so my apologies. eastern central part of the country, (202) 748-8000 fo. mountain-pacific, (202) 748-8001 fo. who gets sick, and why? guest: well, with one out of six americans getting foodborne illness every year, and can be everybody. but those who have a weakened immune system may be more susceptible to serious outcomes if they do get the infection. people who are undergoing cancer chemotherapy, people with hiv, and also pregnant women are more

susceptible to serious infections if they get infected. that is why for those individuals and particular we recommend doing what you can do like washing your hands before you eat, and if you live in an area where the restaurants are graded for food safety, you can look at the food grades. interestingly, in a few of the areas, the cities, that have done food grading, they have seen that the restaurants have gotten much safer and foodborne illness has come down after implementing those grades because restaurants, of course, care about safety and their image. host: where are the bacteria itself coming from? guest: really, the contamination can be anywhere along the food chain. think of a farm animal, a chicken or kyl. -- cow. it is not living in a sterile environment, so there are bacteria in it and on it when it is prepared as food. anywhere along the food chain, when it is worked on with

machinery, there can be contamination of machinery. in the transport, we have seen drippings from an unsafe thing onto the safer food. a contamination in transport, contamination in preparation, or contamination because you didn't wash her hands. host: what about washing the food itself? guest: so, we have looked at thatand the department of agriculture recommends you not wash chicken because the act of washing it can spray bacteria pretty far away and won't get to most of them off. for prewashed greens, we don't see a benefit to washing men -- them. we do recommend rinsing them. you want to be careful to do that where you are not unintentionally splattering bacteria around your kitchen. host: we will go to our first phone call, from bob in indiana, good morning. caller: good morning. consideren, would you

this -- the cases of foodborne argument forood labeling of food products? countries and genetically modified foods. guest: so, we haven't seen a difference in which foods cause illness in terms of genetically modified or other, or in terms of country of origin or other. and the issue of labeling foods is really for the fda and the department of agriculture to determine. but i can say that what is very helpful is when companies track where their foods are coming from, and the food safety modernization act passed a couple of years ago will improve the ability to do that. so when we find an outbreak, being able to trace it back and seeing where it comes from is sometimes very challenging. and the food safety modernization act makes that

substantially easier and something that is quite valuable. it is also very valuable that we are able to do genetic testing of the bacteria that we find, which is called advanced molecular detection. this was an initiative that cdc proposed about three years ago. it is because of that initiative we are able to find outbreaks faster, stop them sooner, and prevent additional cases. host: how do you stop outbreaks? guest: one is to prevent them in the first place with better food practices all along the food chain. them,e second, to stop you have to find them sooner and intervene and get that product off the shelves. inst: and does the cdc -- charge of that? guest: the front lines are local and state health departments. they are dealing with outbreaks all the time. but when it gets into the multistate situation, then we are involved, along with the fda

and usda to do really what is disease detective work. figure out what is the implicated food, what is the food that did it, and then traced that back to where it is coming from, get that off the market, and then see what is happening in that production facility that led to that and learn from that to make other food safer also. host: marilyn in pennsylvania. caller: hi. i have a very simple bit of advice. every time you go out and come back in, you wash your hands thoroughly, dry them thoroughly on a clean towel, and you will do a lot of good. guest: you are absolutely right. in fact, we have seen that regular handwashing has amazing benefits. if you get kids in school to us their hands regularly before the need come after the go to the bathroom, anytime they are soiled, you will see a reduction in all illnesses among the kids

and their teachers that is quite substantial. sometimes the simplest things are the most effective, and handwashing is one of those things. host: dr. frieden, how often do you wash my hands? guest: anytime before i eat, anytime i just recommended. host: dave, florida. caller: yeah, i have a question for the doc. goes, it clean water is quite obvious there is a shortage. even this country probably irrigates other crops, etc. with water. the water is basically unclean, unsanitary, whether it is imported goods or not. it seems to me that everything goes from the food chain from water to feed, the feed goes into the animals, so, you know, when you think about water being contaminated, it is going to affect the whole food chain. and sooner or later it is going to -- with a global

collaboration of importing ingredients that goes into something -- somewhere in the chain, it is going to be contaminated and it is just going to progress from there. i think it is a water issue, as far as irrigation and the basic needs of crops, etc. to feed the world. and that would be my question for the doctor. thank you so much. guest: thank you for that question. you are absolutely correct. we have seen outbreaks related to contaminated water being used to irrigate crops. the bacteria growing into things like tomatoes. but anything that you cook is going to decontaminate or kill the bacteria and viruses within the foodstuff. so, even if something is contaminated, if you'd cook it -- if you cook it adequately,

you are not going to get a bacterial or viral illness. greens, things that we have in salad, that is the biggest challenge because we don't cook them. and many of them come from outside the u.s. and that is why we are working to improve water safety around the world. it is a very important area. in this country, there is still more than one out of four americans is not on a municipal water system. and the safety of those water systems is quite variable. and around the world, there are still over a billion people who don't have regular access to safe, clean water. and that affects them and can affect us because of the lack of adequate sanitation and cleanliness on farms where food is produced. again, if you are cooking something, it is going to kill most of the organisms. -- organisms that might make you sick. host: when the cdc does an investigation, how far back in the food chain does it go?

guest: we have disease detectives, doctors, nurses, scientists, and others who will go to the source to figure it out so we can stop it. we have seen outbreaks where we have had to travel overseas to get to the source. floridaith in palm bay, , go ahead. caller: can you hear me? host: we can. go ahead. caller: your answered almost one, it grows in the products, like a tomato or something. is our food still radiated when it comes into the country? and the second thing -- we went to a food certificate thing where it was only a one-day class but it really gave a good class on how to defrost stuff and how to handle food. and there had always be at least one person with that certificate in the kitchen. and is there any correlation to illnesses going up as people ?eet -- eat more out

or is it in the home and going out to eat? guest: the radiation is used for some, but not all foods. in terms of your second question, the food certificates and training of people who operate restaurants is a local and state decision. but it is clearly the case that training makes a difference. and having a well-trained food safety supervisor on site at all times is associated with a lower risk of getting foodborne illness from a restaurant. in terms of whether restaurants or home cooking or likely to make you more sick, or hard to say. for many of the outbreaks we work on, it is very challenging. people may have been exposed a week ago. think of if you can list everything you have eaten in the past week and from where.

we use things like shopper cards, but we do find that for the restaurant outbreaks, the multistate outbreaks, they tend to be a different type of organism. an organism that can be deadlier because they are contaminating upstream in the food supply a large volume of product, as opposed to home cooked meals where some of the simplest rules -- wash her hands, keep your hot foods hot, your cold foods cold, and don't let the contaminated foods mix with the non-contaminated foods -- you don't want the drippings from the uncooked chicken to get anywhere near your salad. host: dr. frieden, why does it turn out that some of these foodborne illnesses are deadly for some people? guest: well, sometimes it can be that you got a really large dose of the bacteria. sometimes it can be that the bacteria itself is a deadlier

form of it. some forms of e. coli are much deadlier than other forms of e. coli. and other times it is because of the immune system of the person that has been affected. i remember a patient i kid for who got listeria, and he had multiple myeloma, a type of cancer, and it was terribly, terribly difficult to treat his list area infections. it ended up causing terrible problems in many parts of his body and required months to get over that episode. host: what are your recommendations to someone if they think they might have a foodborne illness? is time if actor? -- time a factor? guest: if you have three loose stools in a 24-hour period, that is the definition. if three or more people around you that eight at a commonplace are sick. this is important. if you are having diarrhea and

illness, see your doctor and ask about getting a sample to figure out whether it is a bacteria, and if so, which one. host: and what happens from there? talk about the investigations. so if we takeld -- an imaginary outbreak, a bunch of people eat at a meal together and get very, very sick, they might go to three or four different doctors, maybe they were at a convention and they go to for five different states. the doctors will get a sample of stool for culture. it grows in the laboratory, and then if it grows one of the bacteria we are quite concerned about, that causes illness and multistate outbreaks, it is sent to the state public health lab where they do a simple form of dna fingerprinting. we have a database of over half a million fingerprints of different types, and every week, or in real-time every day, we compare them to see, oh, we have

now three or five or eight cases that match. then we would reach out to the individuals, learn what they ate, identify common exposures, and then from that go back and try to find the source. cdc theu have at the epidemic intelligence service. these are the people that do the investigation. what are their resources like? how much money do they get from congress to echo guest: the in -- congress? guest: the investigations take a whole team. that includes the local and state health departments. it includes our laboratories here in atlanta that are doing cutting-edge work, including some of the molecular genetics that was funded by congress a couple of years ago. officers are disease detectives. they are the front-line troops to investigate and stomp out breaks wherever they occur. we have about 80 per year. it is a two-year service learning program that many of us went through and many of us

remember as a really exciting time in our careers. host: baltimore next, carolyn, good morning. caller: good morning. i would like to ask dr. frieden, is there any type of testing done for the toxin called -- [indiscernible] -- that is commonly contaminates corn crops? guest: that can be a major challenge, and in our cdc laboratories, we have, in fact, one of the top environmental health laboratories in the world. and can do sophisticated testing for that toxin, which can contaminate some crops. in parts of africa, we have seen outbreaks of poisoning, and in those countries that have sometimes implemented programs to track and destroy the contaminated foods before they get distributed and eaten and cause illness because that toxin

can cause liver failure. host: chapel hill, north carolina, john. caller: yes. dr. frieden, good morning. i want to go back to handwashing. my wife and i noticed -- well, we avoid restaurants that don't have towels in the restrooms. just the blowers. because of the go and the restroom, you don't have to sit there very long and what somebody walk out without washing their hands. which means that the people who prepare the food, who also go in those restrooms, will come out and no way will have clean hands. so i would suggest that the cdc or someone ask restaurants to enforce or put towels in the restroom to make it convenient for people to wash their hands and clean their hands thoroughly. that is my comment. guest: it is a very interesting question.

yourink what yor -- theory is is that if restrooms only have the hand dryers and not paper towels, people are less likely to wash their hands. i don't know what the data shows on that, but it is well worth looking at. host: john, chapel hill, north carolina. apologies, allison in texas. caller: hi, good morning. i would like to ask the doctor if he is aware of any legislation that would -- clear from not labeling their meat being sent to the united states. i was under the impression that there was some movement not to label meets from other countries. guest: when we do investigations of outbreaks, it is very important for us to trace all

the food back to its original -- i can'that we can comment on that specific legislation. generally, they are the regulatory agencies in the food safety space. at the cdc, our job is to track what is happening, identify and stop outbreaks, and advance protection. host: dr. frieden, i know you have a busy day and our time with you is ending here shortly. i want to ask you about the flu season and what are your predictions for that. the headline today that the flu shortage means less shots for people. guest: the only thing we can predict with certainty about influenza is that it is unpredictable and we will have a flu season. we can also say the best way to protect yourself against the flu is a flu shot. i got mine. it is our best preventive

measure, but the flu does make a lot of people sick during the winter months. and send hundreds of thousands to the hospital. by all means, get a flu shot. everyone over six months of age should get a flu shot. and if you have a serious underlying health condition and you get something that might be flu, see a doctor because medication can shorten your illness. host: also want to ask you about pandemics. you're at the front lines of what happened in africa with ebola. this was a piece you wrote recently with the headline, " protecting the world from the next pandemic." guest: we know that new organisms and a old organisms in new places are emerging all the time. we discover one per year on average. and some of those can be things like mers, that causes terrible respiratory problems in the middle east, or sars 10 years ago -- or sars 10 years ago in

china, or the next hiv. we really are connected in a global world. we see that in the food supply and we see that in the travel of people around the world. we had two people come back to this country with mers infection a year or so ago. there is a need for us to strengthen the systems all around the world to find, stop, and prevent health threats. that is with the global health security agenda is all about. in doing that will help other countries be safer and keep us safer. host: dr. tom frieden john mealer no co-author of the book sold out.

u.s. companies are abusing the current guestworker program. we will take your calls you can join the conversation on facebook and twitter. washington journal live at 7 a.m. eastern on c-span. >> two things are very different today. we have a justice system. modern.ials are not hearsay is perfectly acceptable nonlawyers. the courtroom is an extremely unruly place. that's one piece of it also we don't happen to believe in witchcraft or prosecuted today.

>> the interesting part about the accusations given the way we think of salem is that wealthy merchants were accused of which is see captains almost five-year-old girls. this is not an instant where all the victims are female we have five male victims including a minister. bonds we hang witches. there was so much encrusted myths and misunderstandings here i thought that was important to us -- to dispel. >> today in washington dc the atlantic coast to the daylong conference on race and criminal system. this part of the event includes magazine correspondent thomas massie code. is three hours.

>> good morning. i am margaret smith of the atlantic and it is wonderful to see you here in this beautiful theater. [applause] >> i run the team behind the event, the race and justice in america and it is fair to say that this theater is the perfect place to hold this summit. it has served the black community, when segregation kept african-americans out of every other venue. billie holiday, louis armstrong, they all performed here, you can just imagine. and then the place shutdown after the riots and it did not open again until the mid-1990's. here we are. decades later and the topic of race and justice in america is as real and ripe as it has ever

been. our gathering today was inspired by a correspondent who wrote the cover story last month. the black family in the age of mass incarceration and in it is -- he examines and understands why we have out incarcerated every other country in the world and what has done for families. many photos here and eliminate -- illuminate network and today we lift that story from the state -- from the page onto the stage, and we will talk about the difficult subjects. we will talk about the role of the courts, learn about life on the frontlines, we'll explore the case for help. -- hope. none of this would be possible without the support of our underwriters, the choice

foundation -- joyce foundation and the jacob and valeria foundation. we will get rolling any moment, but a few notes, we may be steeped in history, but the wi-fi works. atlantic live is the network, race justice 2015 is the twitter handle and in the password. you can join the conversation. we will be taking questions across the day and with that, it is a delight to let the conversation begin. it gives me an enormous pleasure to introduce my colleagues, the editor and chief, james bennett, and our correspondent. [applause] [applause] james: good morning. thank you very